Psychiatry and the Imposition of Upper Middle Class Values

Psychiatrists do not have objective tests to confirm their diagnoses. They are often imposing Upper Middle Class values on their patients and then calling it “scientific” diagnosis.

The National Institutes of Health in May of 2013 declared the methods of American Psychiatry as “lacking in validity” and that “patients deserve better”. Their key criticism was they have no objective test showing that their diagnoses are right. The National Institutes of Health supplies 90% of the funding for medical research in the United States. It is a Federal Government Institution located in Bethesda Maryland and the place where the AIDS virus was discovered and the cure for many cancers developed. It has never criticized any other branch of American Medicine as “lacking in validity.”

Psychiatry used to declare anyone who was gay or lesbian was mentally ill. Alan Turing, the man who invented the electronic computer and then used it to break the Nazi German Military Code, was put in the hands of British psychiatrists because he was gay and forced to undergo hormone shots. He committed suicide because of this at the age 41. The British made a very good movie about him called “Breaking the Code”. He broke two of them.

A lot of people, primarily lower class and children living in lower class or poor households, now get funneled into the psychiatric system in the United States, get labeled according to what are called the DSM criteria –the Diagnostic and Statistical Manual – and then started on medications. There is now an Academic Industrial Complex accelerating this trend. Academicians looking for prestige invent new categories based on clusters of symptoms and then find a drug that will alter this behavior. Pharmaceutical companies are glad to oblige because their profits go up.

The way this Diagnostic Manual works is you make up a list of symptoms and behavior, make up a questionnaire, and if someone answers enough of the questions on the questionnaire as “yes,” you declare them mentally ill. And it is “scientific” because you used a questionnaire and anyone looking at the questionnaire would agree with the “diagnosis”. You can easily see how this made it easy to declare being gay as mentally ill in the early versions of this manual. This was not an illness. This was a value judgment by the upper middle class people of those decades; and psychiatrists were used to impose those values.

Once people are then labeled they change their view of themselves. They are no longer “normal”. They have “intermittent explosive disorder” or some other “diagnosis” and are placed on medication. Often the real problem is they are living in a fairly toxic home environment and anyone would react with that much anger or depression. But now they are the one with the “mental health problem”. Many of these people are children living in homes with multiple problems: drug addicted parents, violence between spouses, poverty, etc. Now 20% of these kids are labeled as “mentally ill” according to a new study by the Centers for Disease Control.

The sad thing is there are people with real mental health problems. They are profoundly depressed. They need real help. They are unable to function or get out of bed in the morning. But now so much money and energy is being diverted to bogus diagnoses that the people who really need help often aren’t getting it. It has even become trendy to have a minor “mental health disorder” and have a therapist for the upper class “worried well”.

If someone has a true severe mental health problem by all means look for help. But be very skeptical of any diagnostic label and anyone who tells you they are “sure they are right” because you fit the criteria. If you think you or your child are being mislabeled find another therapist and never let them control your self esteem or opinion of yourself. They don’t really know what they are taking about. It is not “scientific” even though they claim it is.

From my POV, this is all part of the larger problem with mental health in the US. When a person can even gain access to mental health care in the private insurance “market” morass, what little exists in actual care is incompetent, patently classist in approach, or if you need an expert to deal with a “serious mental illness” they more often than not do not take private insurance. The few that offer a “sliding scale” fee structure decide what that scale is arbitrarily and do so based on owning class values. For a person used to charge $465/40′ session, $165 for a 20′ session seems perfectly reasonable. But for the patient who has to have mandatory private insurance under the Affordable Car act ans is already struggling to come up with a $20 copay for the five MSWs on their plan, $165 for 20′ might as well be a bazillion.

The classism element in mental health care in the US is a pretty deep swamp. I can’t even scratch the tip of my family’s experience with it in a comment.

Diagnosis (“dx”) and Access are only two areas where classism rears its ugly head. Delivery and implementation are another. Interacting with the MHC “professional” and the ability of the lower-middle/working/poor class patient to genuinely be heard is yet another.

Labels are often portrayed as problems. It’s true they can arouse bias from others and erect constraints that shouldn’t be. On the other hand, labels can and do liberate people with brain wiring that is unsupported by social systems, designed by the owning class and regulated by the UMC. Particularly when it comes to kids and American public education.

I had mentioned Alan Turing — http://en.wikipedia.org/wiki/Alan_Turing –who is generally regarded as the father of computer science and one of the most important persons of the 20th century. The early computers were called Turing Machines. He is orders of magnitude more important to computers than Bill Gates or Steve Jobs although he is not as well know to the general public even though he influences most of us every day.

The movie “Breaking the Code” is now available on YouTube. It used to be hard to get and was only on VHS tape but now streams easily at http://www.youtube.com/watch?v=S23yie-779k. David Jacobi plays Alan Turing.

It focuses very much on his mistreatment by the legal system and psychiatry and how this drove him to suicide. The British Prime Minister recently formally apologized publicly for the appalling way he was treated. It’s hard to believe this was only 60 years ago and this is what gay people were subjected to.

Do you know of any statistics or free text articles that show what parts of the country or even specific localities that report the highest numbers of diagnosed mental illnesses? I think state and city budgets for the facilities meant to handle the “mentally ill” are more significant to the quality of care and accuracy of diagnosis than people want to admit who would know.

Given the rising level of class homogeneity in higher education and understanding that is where the psychiatrists come from(an obvious source of the partiality in that field), the bias that upper middle class values have on identifying the mentally is significant if funding needs to be allocated to where it is needed most. There are areas of the country where the “mentally ill” are dumped onto neighboring counties from a county with higher mean family income levels. Systemic marginalization and the effects it has on modes of living being confused with markers of actual mental illness through behavioral checklists is compounded when the environment those misdiagnosed cases are dumped off onto, has even more limited resources and social ills endemic to the factors of poverty that lead to the misdiagnosed cases in the first place.

I don’t know right off the top of my head. I ran a google search as “mental illness statistics in the Unitied States” and a significant number of results pointed towards statistics that the National Institute of Mental Health, and the Department of Health and Human Services would have.

Thanks Pete and I also want to acknowledge the other writers on this topic, Jan Innes and Pilar Gonzales.

I particularly want to cite Inne’s comment before moving on: “Poverty and disability form a common two-way street. While disability often impoverishes its victims, poverty just as readily leads to disability.”

I am part of small grassroots group who have been challenging a very prestigious public school district regarding the savage inequalities directed at children who are poor. One of our many arguments is that the assessments made on children with Individual Education Plans (IEP’s) must consider their class, racial, gender and other experiences in order for them be provided the most effective support for their lives. It is like talking a foreign language to these highly formally educated people…they prefer to individualize the problem as this is what benefits the present system.

Notwithstanding the truth that you make that there are truly people with mental disabilities in the world, we are challenging the school system by making the argument that many of these children are not truly ‘disabled’. That in fact they have been labeled so because they do not fit into the culturally hegemonic box created from the dominant class normative. Children are measured against the upper class yardstick. And when they don’t fit in, they are labeled, tracked, and criminalized (School to Prison Pipeline); harshly treated for what was once normal childish behavior. Violence against children has now been forcibly institutionalized. Many of our children end up dropping out of school, with dead end jobs, needing assistance from welfare, mental health issues, drug addiction, and prison, to name some consequences. Thanks to the corporatization of education, this now begins in Head Start.

Capitalism is not reformable, it is tragically maiming lives every day, all around the world. A system based on private property and individual profit will always benefit those who own: the ruling class and its offspring the middle-class. We must continue, and for those who have not begun, to think bravely, differently, creatively, and whether you want or don’t want to call it socialism, communism, anarchism, etc., a fundamental change in the present political, economic, and cultural system is the only choice.

I would like to end with a quote from Marcos, a spokesperson for the Zapatistas in Chiapas:

“The storm is here. From the clash of these two winds the storm will be born, its time has arrived. Now the wind from above rules, but the wind from below is coming…. The prophecy is here. When the storm calms, when rain and fire again leave the country in peace, the world will no longer be the world but something better.” Chiapas: The Southeast in Two Winds (August 1992

I found this article while looking for information on how to cope with someone who subliminates. I find subliminal behavior scary because I don’t understand it.
I’m writing because I was one of the children Mr. Daly mentions who responded normally to a toxic home. I’m lucky I was not taken to a psychiatrist – neither of my parents cared that much – and that although I had no idea what I was doing, my instincts were good enough to make me rebel against authority that was always judging and condemming me. I knew I didn’t deserve that. I left my home town and moved to a big city when I was 22, and that saved me. Within a few years of moving I followed the clinic system to a psychologist who determined I did not have clinical depression or another disorder – I was responding normally to my parents. I focused on learning to have a happy life with healthy relationships instead of career or marriage. In the decades since then I stopped trying to have relationships with my parents and did much better, although I have post-traumatic stress which is now being addressed with one of the few good therapists and EMDR.
My brother did not move to a big city and continued to have relationships with my parents. He has focused on career and lived where his job was even if he didn’t like the the town. He has been on meds for depression and anxiety and when he committed to a career move that was too stressful he became very obese and said he was having a nervous breakdown. I’ve tried to help him, but he has become more and more like our mother and our relationship has suffered.
My own experience has taught me that Mr. Daly is correct, and I’m very glad I rebelled against the cold, judgmental culture instead of submitting to it. That would have made me suicidal.